The dermatan sulfate proteoglycans of the adult human meniscus

The Importance of the Knee Joint Meniscal Fibrocartilages as Stabilizing Weight Bearing Structures Providing Global Protection to Human Knee-Joint Tissues

The aim of this study was to review aspects of the pathobiology of the meniscus in health and disease and show how degeneration of the meniscus can contribute to deleterious changes in other knee joint components. The menisci, distinctive semilunar weight bearing fibrocartilages, provide knee joint stability, co-ordinating functional contributions from articular cartilage, ligaments/tendons, synovium, subchondral bone and infra-patellar fat pad during knee joint articulation. The meniscus contains metabolically active cell populations responsive to growth factors, chemokines and inflammatory cytokines such as interleukin-1 and tumour necrosis factor-alpha, resulting in the synthesis of matrix metalloproteases and A Disintegrin and Metalloprotease with ThromboSpondin type 1 repeats (ADAMTS)-4 and 5 which can degrade structural glycoproteins and proteoglycans leading to function-limiting changes in meniscal and other knee joint tissues. Such degradative changes are hall-marks of osteoarthritis (OA). No drugs are currently approved that change the natural course of OA and translate to long-term, clinically relevant benefits. For any pharmaceutical therapeutic intervention in OA to be effective, disease modifying drugs will have to be developed which actively modulate the many different cell types present in the knee to provide a global therapeutic. Many individual and combinatorial approaches are being developed to treat or replace degenerate menisci using 3D printing, bioscaffolds and hydrogel delivery systems for therapeutic drugs, growth factors and replacement progenitor cell populations recognising the central role the menisci play in knee joint health.

Ectopic expression of Smurf2 and acceleration of age-related intervertebral disc degeneration in a mouse model

OBJECTIVE

Lumbar intervertebral disc degeneration, an age-related process, is a major cause of low-back pain. Although low-back pain is a very common clinical problem in the aging population, no effective treatment is available, largely owing to lack of understanding of the molecular mechanisms underlying disc degeneration. The goal of this study was to characterize how ectopic expression of Smurf2 driven by the collagen Type II alpha 1 (Col2a1) promoter alters disc cell phenotype and associated cellular events, matrix synthesis, and gene expression during disc degeneration in mice.

METHODS

To characterize how ectopic expression of Smurf2 in Col2a1-promoter working cells affects the disc degeneration process, the authors performed histological and immunohistochemical analysis of lumbar spine specimens harvested from wild-type (WT) and Col2a1-Smurf2 transgenic mice at various ages (n ≥ 6 in each age group). To elucidate the molecular mechanism underlying Smurf2-mediated disc degeneration, the authors isolated cells from WT and Col2a1-Smurf2 transgenic lumbar intervertebral discs and performed Western blot and real-time RT-PCR (reverse transcription polymerase chain reaction) to examine the protein and mRNA levels of interesting targets.

RESULTS

The authors demonstrated that approximately 30% of WT mice at 10–12 months of age had started to show disc degeneration and that the disc degeneration process was accelerated by 3–6 months in Col2a1-Smurf2 transgenic mice. Chondrocyte-like cell proliferation, maturation, and fibrotic tissue formation in the inner annulus were often accompanied by fibroblast-to-chondrocyte differentiation in the outer annulus in transgenic discs. The chondrocyte-like cells in transgenic discs expressed higher levels of connective tissue growth factor (CTGF) than were expressed in WT counterparts.

CONCLUSIONS

The findings that ectopic expression of Smurf2 driven by the Col2a1 promoter accelerated disc degeneration in Col2a1-Smurf2 transgenic mice, and that higher levels of CTGF protein and mRNA were present in Col2a1-Smurf2 transgenic discs, indicate that Smurf2 accelerates disc degeneration via upregulation of CTGF.

Matrix formation is enhanced in co-cultures of human meniscus cells with bone marrow stromal cells

The ultimate aim of this study was to assess the feasibility of using human bone marrow stromal cells (BMSCs) to supplement meniscus cells for meniscus tissue engineering and regeneration. Human menisci were harvested from three patients undergoing total knee replacements. Meniscus cells were released from the menisci after collagenase treatment. BMSCs were harvested from the iliac crest of three patients and were expanded in culture until passage 2. Primary meniscus cells and BMSCs were co-cultured in vitro in three-dimensional (3D) pellet culture at three different cell-cell ratios for 3 weeks under normal (21% O2 ) or low (3% O2 ) oxygen tension in the presence of serum-free chondrogenic medium. Pure BMSCs and pure meniscus cell pellets served as control groups. The tissue generated was assessed biochemically, histochemically and by quantitative RT-PCR. Co-cultures of primary meniscus cells and BMSCs resulted in tissue with increased (1.3-1.7-fold) deposition of proteoglycan (GAG) extracellular matrix (ECM) relative to tissues derived from BMSCs or meniscus cells alone under 21% O2 . GAG matrix formation was also enhanced (1.3-1.6-fold) under 3% O2 culture conditions. Alcian blue staining of generated tissue confirmed increased deposition of GAG-rich matrix. mRNA expression of type I collagen (COL1A2), type II collagen (COL2A1) and aggrecan were upregulated in co-cultured pellets. However, SOX9 and HIF-1α mRNA expression were not significantly modulated by co-culture. Co-culture of primary meniscus cells with BMSCs resulted in increased ECM formation. Co-delivery of meniscus cells and BMSCs can, in principle, be used in tissue engineering and regenerative medicine strategies to repair meniscus defects.

Glycosaminoglycan composition of the vocal fold lamina propria in relation to function

OBJECTIVES

This study was designed to quantify the specific glycosaminoglycans (GAGs) in the midmembranous vocal fold (VF) lamina propria (LP) and to interpret their presence in relation to the known stresses borne by each LP layer.

METHODS

GAGs from normal human LP and from both normal and scarred canine LPs were analyzed by fluorophore-assisted carbohydrate electrophoresis (FACE). Immunostaining was conducted to give insight into the spatial distribution of each GAG type.

RESULTS

Hyaluronan composes roughly 0.64% +/- 0.41% of the human LP as measured relative to tissue total protein. Chondroitin sulfate and/or dermatan sulfate (CS/DS), keratan sulfate, and heparan sulfate chains constitute approximately 23.9% +/- 12.1%, 14.7% +/- 6.1%, and 61.4% +/- 13.6%, respectively, of human LP sulfated GAGs.

CONCLUSIONS

Observed CS/DS sulfation patterns imply that versican is a major contributor to human LP CS levels. In addition, examination of LP GAG with respect to gender revealed a significant variation in total levels of CS/DS and a potential difference in the levels of versican relative to decorin and biglycan. In dogs, LP scarring appeared to result in a reduction in hyaluronan and CS/DS. These FACE results were combined with histologic data to update current descriptive models linking LP microstructure with the regional variations in LP loading.

Human meniscus cells express hypoxia inducible factor-1alpha and increased SOX9 in response to low oxygen tension in cell aggregate culture

In previous work we demonstrated that the matrix-forming phenotype of cultured human cells from whole meniscus was enhanced by hypoxia (5% oxygen). Because the meniscus contains an inner region that is devoid of vasculature and an outer vascular region, here we investigate, by gene expression analysis, the separate responses of cells isolated from the inner and outer meniscus to lowered oxygen, and compared it with the response of articular chondrocytes. In aggregate culture of outer meniscus cells, hypoxia (5% oxygen) increased the expression of type II collagen and SOX9 (Sry-related HMG box-9), and decreased the expression of type I collagen. In contrast, with inner meniscus cells, there was no increase in SOX9, but type II collagen and type I collagen increased. The articular chondrocytes exhibited little response to 5% oxygen in aggregate culture, with no significant differences in the expression of these matrix genes and SOX9. In both aggregate cultures of outer and inner meniscus cells, but not in chondrocytes, there was increased expression of collagen prolyl 4-hydroxylase (P4H)α(I) in response to 5% oxygen, and this hypoxia-induced expression of P4Hα(I) was blocked in monolayer cultures of meniscus cells by the hypoxia-inducible factor (HIF)-1α inhibitor (YC-1). In fresh tissue from the outer and inner meniscus, the levels of expression of the HIF-1α gene and downstream target genes (namely, those encoding P4Hα(I) and HIF prolyl 4-hydroxylase) were significantly higher in the inner meniscus than in the outer meniscus. Thus, this study revealed that inner meniscus cells were less responsive to 5% oxygen tension than were outer meniscus cells, and they were both more sensitive than articular chondrocytes from a similar joint. These results suggest that the vasculature and greater oxygen tension in the outer meniscus may help to suppress cartilage-like matrix formation.

The Regenerative Effects of Platelet-Rich Plasma on Meniscal CellsIn Vitroand ItsIn VivoApplication with Biodegradable Gelatin Hydrogel

The objective of the study was to test the hypothesis that platelet-rich plasma (PRP) enhances meniscal tissue regeneration in vitro and in vivo. In the in vitro study, monolayer meniscal cell cultures were prepared, and 3-(4,5-dimethylthiazol-2yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium inner salt assay and 5-bromo-2'-deoxyuridine assay were performed to assess proliferative behavior in the presence of PRP. Alcian blue assay was performed to assess extracellular matrix (ECM) synthesis. To detect the fibrocartilage-related messenger ribonucleic acid (mRNA) expressions, real-time polymerase chain reaction was performed. In the in vivo study, 1.5-mm-diameter full-thickness defects were created in the avascular region of rabbit meniscus. Gelatin hydrogel (GH) was used as the drug delivery system for PRP growth factors. The defects were filled as follows: Group A, GH with PRP; Group B, GH with platelet-poor plasma; Group C, GH only. Each group was evaluated histologically at 4, 8, and 12 weeks after surgery. PRP stimulated deoxyribonucleic acid synthesis and ECM synthesis (p<0.05). Meniscal cells cultured with PRP showed greater mRNA expression of biglycan and decorin (p<0.05). Histological findings showed that remnants of gelatin hydrogels existed at 4 weeks, indicating that the hydrogels could control release for approximately 4 weeks. Histological scoring of the defect sites at 12 weeks revealed significantly better meniscal repair in animals that received PRP with GH than in the other two groups. These findings suggest that PRP enhances the healing of meniscal defects.

Region-specific constitutive gene expression in the adult porcine meniscus

The knee meniscus exhibits extensive spatial variations in native healing capacity, biochemical composition, and cell morphology that suggest the existence of distinct phenotypes for meniscus cells. Constitutive gene expression levels of appropriate extracellular matrix proteins may serve as useful molecular markers of cellular phenotypes; however, relatively little is known of variations in the gene expression for meniscus cells of different regions of the tissue. The objective of the present study was to evaluate constitutive differences between radial inner and outer regions in gene expression for extracellular matrix proteins relevant to the meniscus. A secondary objective was to determine if these region-specific differences in gene expression are maintained after periods of monolayer culture. The innermost regions of the meniscus were found to constitutively express higher mRNA levels for proteins highly expressed in articular cartilage, including aggrecan, type II collagen, and NOS2. In contrast, the outer meniscus was found to contain higher gene expression for proteins associated with fibrous tissues including type I collagen, and the proteases MMP2 and MMP3. Isolated inner and outer meniscus cells maintained these region-specific gene expression patterns for collagens and proteoglycans during short-term monolayer culture. The results provide new information that suggests the utility of constitutive gene expression levels as molecular markers to distinguish tissue and cells of the inner and outer meniscus.

Finite element modeling predictions of region-specific cell-matrix mechanics in the meniscus

The knee meniscus exhibits significant spatial variations in biochemical composition and cell morphology that reflect distinct phenotypes of cells located in the radial inner and outer regions. Associated with these cell phenotypes is a spatially heterogeneous microstructure and mechanical environment with the innermost regions experiencing higher fluid pressures and lower tensile strains than the outer regions. It is presently unknown, however, how meniscus tissue mechanics correlate with the local micromechanical environment of cells. In this study, theoretical models were developed to study mechanics of inner and outer meniscus cells with varying geometries. The results for an applied biaxial strain predict significant regional differences in the cellular mechanical environment with evidence of tensile strains along the collagen fiber direction of approximately 0.07 for the rounded inner cells, as compared to levels of 0.02-0.04 for the elongated outer meniscus cells. The results demonstrate an important mechanical role of extracellular matrix anisotropy and cell morphology in regulating the region-specific micromechanics of meniscus cells, that may further play a role in modulating cellular responses to mechanical stimuli.

Biaxial strain effects on cells from the inner and outer regions of the meniscus

During knee joint loading, the fibrocartilaginous menisci experience significant spatial variations in mechanical stimuli. Meniscus cells also exhibit significant variations in biosynthesis and gene expression depending on their location within the tissue. These metabolic patterns are consistent with a more chondrocytic phenotype for cells located within the avascular inner two-thirds compared with a more fibroblastic phenotype for cells within the vascularized outer periphery. The spatial distribution of cell biosynthesis and gene expression patterns within the meniscus suggest that cells may exhibit intrinsically different responses to mechanical stimuli. The objective of our study was to test for intrinsic differences in the responsiveness of these meniscus cell populations to an equivalent mechanical stimulus. Cellular biosynthesis and gene expression for extracellular matrix proteins in isolated inner and outer meniscus cells in monolayer were quantified following cyclic biaxial stretch. The results demonstrate that inner and outer meniscus cells exhibit significant differences in matrix biosynthesis and gene expression regardless of stretching condition. Both inner and outer meniscus cells responded to stretch with increased nitric oxide production and total protein synthesis. The results suggest that inner and outer meniscus cells may respond similarly to biaxial stretch in vitro with measures of biosynthesis and gene expression.

Differential effects of static and dynamic compression on meniscal cell gene expression

Cells of the meniscus are exposed to a wide range of time-varying mechanical stimuli that may regulate their metabolic activity in vivo. In this study, the biological response of the meniscus to compressive stimuli was evaluated in vitro, using a well-controlled explant culture system. Gene expression for relevant extracellular matrix proteins was quantified using real-time RT-PCR following a 24 h period of applied static (0.1 MPa compressive stress) or dynamic compression (0.08-0.16 MPa). Static and dynamic compression were found to differentially regulate mRNA levels for specific proteins of the extracellular matrix. Decreased mRNA levels were observed for decorin ( approximately 2.1 fold-difference) and type II collagen ( approximately 4.0 fold-difference) following 24 h of dynamic compression. Decorin mRNA levels also decreased following static compression ( approximately 4.5 fold-difference), as did mRNA levels for both types I ( approximately 3.3 fold-difference) and II collagen ( approximately 4.0 fold-difference). Following either static or dynamic compression, mRNA levels for aggrecan, biglycan and cytoskeletal proteins were unchanged. It is noteworthy that static compression was associated with a 2.6 fold-increase in mRNA levels for collagenase, or MMP-1, suggesting that the homeostatic balance between collagen biosynthesis and catabolism was altered by the mechanical stimuli. These findings demonstrate that the biosynthetic response of the meniscus to compression is regulated, in part, at the transcriptional level and that transcription of types I and II collagen as well as decorin may be regulated by common mechanical stimuli.

Glycosaminoglycan profiles of myxomatous mitral leaflets and chordae parallel the severity of mechanical alterations

OBJECTIVES

This biochemical study compared the extracellular matrix of normal mitral valves and myxomatous mitral valves with either unileaflet prolapse (ULP) or bileaflet prolapse (BLP).

BACKGROUND

Myxomatous mitral valves are weaker and more extensible than normal valves, and myxomatous chordae are more mechanically compromised than leaflets. Despite histological evidence that glycosaminoglycans (GAGs) accumulate in myxomatous valves, previous biochemical analyses have not adequately examined the different GAG classes.

METHODS

Leaflets and chordae from myxomatous valves (n = 41 ULP, 31 BLP) and normal valves (n = 27) were dried, dissolved, and assayed for deoxyribonucleic acid, collagen, and total GAGs. Specific GAG classes were analyzed with selective enzyme digestions and fluorophore-assisted carbohydrate electrophoresis.

RESULTS

Biochemical changes were more pronounced in chordae than in leaflets. Myxomatous leaflets and chordae had 3% to 9% more water content and 30% to 150% higher GAG concentrations than normal. Collagen concentration was slightly elevated in the myxomatous valves. Chordae from ULP had 62% more GAGs than those from BLP, primarily from elevated levels of hyaluronan and chondroitin-6-sulfate.

CONCLUSIONS

The GAG classes elevated in the myxomatous chordae are associated with matrix microstructure and elastic fiber deficiencies and may influence the hydration-related "floppy" nature of these tissues. These abnormalities may be related to the reported mechanical weakness of myxomatous chordae. The biochemical differences between ULP and BLP confirm previous mechanical and echocardiographic distinctions.

Loss of chondroitin 6-sulfate and hyaluronan from failed porcine bioprosthetic valves

Explanted porcine bioprosthetic valves have a thinned spongiosa, partially because of an overall loss of glycosaminoglycans (GAGs). We measured the concentrations of specific GAG classes in explanted bioprosthetic valves (n = 14, implanted 12.0 +/- 4.7 years) compared with glutaraldehyde-fixed porcine controls. After extraction with NaOH, GAGs were analyzed using either a hexuronic acid assay or fluorophore-assisted carbohydrate electrophoresis to quantify the individual GAG classes. The total GAG concentration in explants was 198 +/- 95 pmol/mg wet weight-93% less than freshly fixed controls. Explants also contained altered proportions of the different GAG classes relative to controls. The proportions of hyaluronan and chondroitin/dermatan-6-sulfate were reduced from 39 to 7% and 34 to 18% of total GAGs, respectively. The predominant explant GAG class was chondroitin/dermatan-4-sulfate (proportion elevated from 14 to 70%). This GAG is commonly found in the collagen-associated proteoglycan decorin, which is likely well crosslinked by glutaraldehyde. Chondroitin-6-sulfate is commonly found in the water- and hyaluronan-binding proteoglycan versican, which is likely poorly crosslinked. The loss of versican and its associated water-binding capacity is consistent with the thinned spongiosa. The resultant compromise of hydration, compressive resistance, and viscoelasticity may be responsible for the deterioration of the bioprosthesis in vivo.

Characterization of glycosaminoglycans from human normal and scoliotic nasal cartilage with particular reference to dermatan sulfate

The composition and the distribution of glycosaminoglycans (GAGs) present in normal human nasal cartilage (HNNC), were examined and compared with those in human scoliotic nasal cartilage (HSNC). In both tissues, hyaluronan (HA), keratan sulfate (KS) and the galactosaminoglycans (GalAGs)--chondroitin sulfate (CS) and dermatan sulfate (DS)--were identified. The overall GAG content in HSNC was approx. 30% higher than the HNNC. Particularly, a 114% increase in HA, and 46% and 86% in KS and DS, respectively, was recorded. CS was the main type of GAG in both tissues with no significant compositional difference. GalAG chains in HSNC exhibited an altered disaccharide composition which was associated with significant increases of non-sulfated and 6-sulfated disaccharides. DS, which was identified and quantitated for the first time in HNNC and HSNC, contained low amounts of iduronic acid (IdoA), 18% and 28% respectively. In contrast to other tissues, where IdoA residues are organized in long IdoA rich repeats, the IdoA residues of DS in human nasal cartilage seemed to be randomly distributed along the chain. DS chains in HSNC were of larger average molecular size than those from HNNC. These results clearly indicate the GAG content and pattern in both HNNC and HSNC and demonstrate that scoliosis of nasal septum cartilage is related to quantitative and structural modifications at the GAG level.

Absolute concentrations of mRNA for type I and type VI collagen in the canine meniscus in normal and ACL-deficient knee joints obtained by RNase protection assay

Relatively little is known about the cellular and molecular responses of the knee joint meniscus to joint injury, despite the functional importance of the tissue. We investigated how meniscus cells respond to joint injury in the early stages of post-traumatic osteoarthritis by characterizing the changes in matrix gene expression in menisci at 3 and 12 weeks post-surgery in dogs in which the anterior cruciate ligament (ACL) in one joint was transected and the other unoperated joint served as a control. Changes in the total RNA and DNA concentrations of the menisci were determined. Absolute concentrations of the mRNA of the COL1A1 gene of type 1 collagen, the major fibrillar collagen of the meniscus, and the COL6A3 gene of type VI collagen, a major repair molecule, were determined by quantitative ribonuclease (RNase) protection assay. The concentration of total RNA in medial and lateral menisci increased from 40 to 60 microg RNA/g wet wt in unoperated, control joints to 200-350 microg RNA/g wet wt in ACL-deficient joints. No significant changes were detected in the concentration of DNA (900-1200 microg DNA/g wet wt). Low concentrations of COL1A1 (2-3 pmol mRNA/g DNA) and COL6A3 (0.3-0.6 pmol mRNA/g DNA) mRNA transcripts were measured in normal menisci. ACL-deficiency induced a 20-38 fold increase in COL1A1 and COL6A3 mRNA concentration at 3 weeks, and an 11-19 fold increase at 12 weeks post-surgery. In general, the increase in COL1A1 and COL6A3 mRNA concentrations was greater in medial menisci than in lateral menisci. These results demonstrate that the menisci initiate a vigorous biosynthetic response to transection of the ACL.

Determination and structural characterisation of dermatan sulfate in the presence of other galactosaminoglycans

Chondroitin sulfate and dermatan sulfate are galactosaminoglycans that have similar size and charge density thus making difficult their separation and accurate determination from tissue preparations. A procedure was developed, which was based on the specific action of chondroitinase B, that allowed the determination of dermatan sulfate content in a mixture of chondroitin sulfate/dermatan sulfate, its molecular mass (Mr), and iduronic acid content and distribution throughout the chain. According to this procedure, the galactosaminoglycan sample was treated with chondroitinase B and its profile, upon gel chromatography on Sepharose CL-6B, was compared to that of the initial sample. The differences in uronic acid content of the fractions of the gel chromatographies were plotted and a secondary profile was constructed, which corresponded to the elution profile of intact dermatan sulfate in the sample. From this profile, the size distribution of dermatan sulfate was obtained and its Mr was calculated. In addition, the accurate content of dermatan sulfate in the sample was determined. The digest contained oligosaccharides of variable size that were separated on BioGel P-10. From the separated oligosaccharides the distribution of iduronic acid throughout the dermatan sulfate chains was determined. The procedure was applied to the determination and partial characterisation of dermatan sulfate from sheep nasal cartilage, in which it is reported for the first time that it contains a significant proportion of dermatan sulfate chains of low iduronic acid content.

Age-related changes in the synthesis and mRNA expression of decorin and aggrecan in human meniscus and articular cartilage

OBJECTIVE

To determine if the biosynthesis of aggrecan and decorin in the human meniscus and the potential of the cells to express these macromolecules (mRNA), is affected by the age of the individual and that if any changes are observed are they different to those measured in articular cartilage obtained from the same joint.

DESIGN

Radiolabelling of tissue explants, anion-exchange chromatography and agarose-polyacrylamide gel electrophoresis were used to analyze newly synthesized proteoglycans. A quantitative, competitive reverse-transcriptase polymerase chain reaction was developed and applied to the tissue to measure the expression of decorin and aggrecan mRNA.

RESULTS

Proteoglycan synthesis in the meniscus was higher in young donors (1-5 mmoles sulfate incorporated/h/mgDNA, under 20 years of age) than in adult tissues (0.5-1 mmoles incorporated/h/mgDNA, 20-62 years of age) and decorin was the major proteoglycan synthesized at this time. An age-related increase in the proportion of aggrecan synthesis in the meniscus was also observed using agarose-polyacrylamide gel electrophoresis. Both decorin (five-fold) and aggrecan (eight-fold) mRNA expression increased with age in meniscus whereas levels were relatively constant in articular cartilage. In addition, the synthesis of decorin and aggrecan and the expression of their mRNA was different in meniscus and articular cartilage from the same knee joint.

CONCLUSION

The synthesis and turnover of aggrecan and decorin in the human meniscus is influenced by the age of the individual and is not the same as that observed for articular cartilage.

Effects of intraoral splint wear on proteoglycans in the temporomandibular joint disc

Intraoral splints are a common dental treatment for dysfunctions of the temporomandibular joint (TMJ), but their effects on the structures of the joint, specifically the disc, have not been well investigated. This study examined proteoglycans (PGs) of the TMJ disc of the miniature pig and tested for alterations resulting from intraoral splint wear. Sixteen female pigs were divided into three groups: control (C), control splint (CS), and protrusive splint (PS). Splinted groups received chrome-cobalt ramp splints which were worn continuously for 2 months. PG content within various disc locations was determined by colorimeteric assay. PG synthesis and type were examined by labeling with (35)S-sulfate and SDS-PAGE analysis. Average water content of the disc was 77.1%, which places it at the high end of the normal range for collagenous biomaterials (60-80%). PGs migrating to the positions typical of aggrecan, biglycan, and decorin on SDS-PAGE were present in all locations of all groups. The highest content and synthesis of PGs were always found in the intermediate band of the disc regardless of group (P < 0.05), supporting the notion that this band encounters heavy compressive loading during function. The joints of animals from both splinted groups showed a high frequency of gross pathology. Biglycan synthesis was increased in both splinted groups (P < 0.05). Newly synthesized biglycan had a shorter migration distance in the intermediate bands of the CS group, suggesting increased hydrodynamic size. These findings suggest that intraoral splint wear may cause disc damage or remodeling.

Gene expression in menisci from the knees of skeletally immature and mature female rabbits

This study, using the sensitive molecular technique of semiquantitative reverse transcription-polymerase chain reaction, evaluated mRNA levels for several molecules in medial and lateral menisci from the knees of skeletally mature and immature rabbits. Total RNA was extracted from the medial and lateral menisci of New Zealand White rabbits with the TRIspin method. Total RNA and DNA were similar in the two menisci of both immature and mature rabbits. The total RNA was reverse-transcribed and analyzed by semiquantitative polymerase chain reaction using rabbit-specific primer sets; levels of mRNA for a subset of molecules differed between the medial and lateral menisci. These variations in mRNA levels were also influenced by the degree of skeletal maturity of the rabbits. For most of the genes, mRNA levels were generally higher in the medial than in the lateral meniscus. The medial meniscus from immature and mature rabbits had significantly increased levels of mRNA for molecules such as transforming growth factor-beta, cyclooxygenase-2, and tissue inhibitor of metalloprotease-1. In contrast, compared with mRNA in the lateral meniscus, that for types II and III collagen, biglycan, insulin-like growth factor-2, plasminogen activator inhibitor-1, and matrix metalloprotease-1 was significantly increased in the medial meniscus of mature rabbits only and that for versican and type-I collagen was significantly increased in the medial meniscus of immature rabbits only. Levels of mRNA for inducible nitric oxide synthase and basic fibroblast growth factor were similar in both menisci for both age groups. The present study demonstrates that regulation of mRNA levels in medial and lateral menisci is tissue-specific and influenced by the skeletal maturity of the animals.

Fibrocartilages in the extensor tendons of the interphalangeal joints of human toes

The extensor tendons of the fingers and toes form part of the capsule of the interphalangeal joint and press against the proximal phalanx during flexion. Previous work on the fingers has shown that there is a "sesamoid" fibrocartilage on the deep surface of each tendon that labels immunohistochemically for a variety of glycosaminoglycans and collagens. However, we know little about the molecular composition of the tendon in the toes. This question is of special interest, because the mechanics of the interphalangeal joints differ in the upper and lower limbs-the toes balance the forefoot, distribute load during the gait cycle, and transmit the pull of larger muscles. This means that their extensor tendons are more often under higher tension than those in the fingers. Here, we report the presence of an equivalent fibrocartilage and compare its immunolabelling characteristics in all the toes. Six forefeet were removed from elderly cadavers, and the interphalangeal (IP) joints were fixed in 90% methanol. The extensor tendon and its enthesis were dissected out from the IP joint of the big toe and from the proximal interphalangeal (PIP) joint of all lesser toes, decalcified, cryosectioned, and immunolabelled with a panel of monoclonal and polyclonal antibodies for type I, II, III, and VI collagens; chondroitin 4 and 6 sulphates; and dermatan and keratan sulphate. Antibody binding was detected with the Vectastain ABC Elite avidin-biotin-peroxidase kit (Vector Laboratories, Burlingame, CA). The extensor tendon in all the toes had a metachromatic, sesamoid fibrocartilage on its deep surface that immunolabelled for all glycosaminoglycans and for type I, III, and VI collagens. Labelling for type II collagen was seen in the sesamoid fibrocartilage of all toes but was particularly characteristic of the 2nd through 5th toes. The immunolabelling patterns of the enthesis fibrocartilage were similar in all toes and to results reported previously for fingers. The normal occurrence of type II collagen in the sesamoid fibrocartilage of the 2nd through 5th toes is in contrast to our published data on the fingers. The finding can be related to the more constant loading of the tendon in the toes. The greater prominence of type II collagen in the sesamoid fibrocartilage of the 2nd through 5th toes could be related to a difference in joint position during walking between the 1st toe and the 2nd through 5th toes--the PIP joints of the latter are usually more flexed than the IP joint of the former.

Matrix protein mRNA levels in canine meniscus cells in vitro

The resident cells of the meniscus synthesize a fibrocartilaginous extracellular matrix in vivo composed predominantly of type I collagen fibers. To increase our understanding of matrix biosynthesis by meniscus cells in vitro, we examined matrix protein mRNA levels in cultured meniscus cells isolated from skeletally mature dogs. The mRNA levels of five matrix protein genes (COL1A1, COL2A1, aggrecan, COL6A1, and fibronectin) were measured in meniscus cells by Northern blotting and compared with those of patellar tendon fibroblasts and femoral articular cartilage chondrocytes. In freshly isolated cells (Day 0 cells), COL1A1, COL2A1, and aggrecan mRNA levels were low or undetectable in both meniscus cells and tendon fibroblasts. In intact meniscus tissue, COL1A1 mRNA levels were also low or undetectable. COL2A1 and aggrecan mRNA transcripts were readily observed, however, in Day 0 articular chondrocytes. The levels of expression of COL6A1 and fibronectin mRNA transcripts in Day 0 meniscus cells were intermediate between higher articular chondrocyte levels and lower tendon fibroblast levels. After 1 week in monolayer culture (Day 7 cells), meniscus cells expressed readily detectable levels of COL1A1 mRNA transcripts, similar to that observed for cultured tendon fibroblasts. COL1A1 mRNA transcripts were either not detected or detected at very low levels in monolayer cultures of articular chondrocytes. COL2A1 and aggrecan mRNA transcripts were readily detected in cultured articular chondrocytes but not in meniscus cells or in tendon fibroblasts. All three types of cells continued to express COL6A1 and fibronectin mRNA transcripts after 1 week in culture. These results demonstrate that the patterns of expression of COL1A1 and COL2A1 mRNA transcripts by meniscus cells are similar to those of tendon fibroblasts and dissimilar to those of articular chondrocytes both in freshly isolated cells and in monolayer cultured cells. This mRNA expression pattern supports the idea that monolayer culture of meniscus cells results in the expression of a predominantly fibroblastic phenotype.

Knee joint immobilization decreases aggrecan gene expression in the meniscus

Aggrecan is the major proteoglycan of the meniscus, and its primary function is to give the meniscus its viscoelastic compressive properties. The objective of this study was to determine the effect of joint immobilization on aggrecan gene expression in the meniscus. The right hindlimbs of six mature beagles were knee cast-immobilized in 90 degrees of flexion and supported by a sling to prevent weightbearing, while the contralateral limb was left free to bear weight. The animals were sacrificed at 4 weeks, and the anterior and posterior halves of the medial and lateral menisci were analyzed separately. Analysis of aggrecan gene expression by quantitative polymerase chain reaction showed decreased aggrecan gene expression in menisci from immobilized knees (P < 0.01, two-way analysis of variance). Aggrecan gene expression decreased by a factor of 2 to 5.5 in the different regions examined. Analysis of the composition of the meniscus also showed decreased proteoglycan content and increased water content with immobilization (P < 0.05, two-way analysis of variance). These results show that joint immobilization can significantly affect meniscal cellular activity and composition and can therefore potentially affect meniscal function.

Elevated synthesis of biglycan and decorin in an ovine annular lesion model of experimental disc degeneration

The aim of this study was to extend our earlier observations on the changes that occur in the proteoglycans (PGs) of discs subjected to experimental injury to the annulus fibrosus (AF). We employed the alginate bead culture method to examine the metabolism of the dermatan sulphate (DS) containing PGs by cells derived from different regions of ovine discs that had been subjected to experimental annular injury. This was compared with the metabolism of the DS-PGs by cells isolated from equivalent regions of normal sham-operated discs. Six months after induction of the annular lesion, AF cells isolated from the lesion produced significantly higher levels of decorin and biglycan in alginate bead culture than did cells from equivalent zones of the controls. Decorin and biglycan were identified in culture media samples by immunoblotting, using specific antibodies (6-B-6, LF-96), and also by positive identification of their de-glycosylated core proteins. The core protein of the DS-PGs has been shown to inhibit type I/II collagen fibrillogenesis, to negatively regulate the action of transforming growth factor-beta (TGF-beta) and to diminish cellular proliferation in vitro; events which may be detrimental to tissue repair. The findings are therefore consistent with our previous observation the annular lesions in the avascular inner annulus have no capacity to heal.

Isolation and characterization of small proteoglycans from different zones of the porcine knee meniscus

Pig knee menisci were dissected into three zones of equal width representing inner, i.e. medial (zone 1), middle (zone 2) and outer, i.e. lateral (zone 3) tissue. Proteoglycans (PGs) were extracted with guanidinium chloride, isolated by ion-exchange chromatography and separated into two groups ('small' and 'large') by gel filtration. The small PGs were further fractionated by hydrophobic-interaction chromatography on Octyl-Sepharose. The PG eluting earliest from Octyl-Sepharose was identified as decorin on the basis of the size of the protein core produced by digestion with chondroitinase ABC, its recognition by monoclonal antibodies raised against bovine decorin and its N-terminal sequence, 23 of 24 amino acids of which were identified. Decorin represented about 23%, 28% and 32% of the total small PG recovered from Octyl-Sepharose from zones 1, 2 and 3, respectively. The major small PG in the meniscus, eluting from Octyl-Sepharose after decorin, was identified as biglycan by the size of core, recognition by a polyclonal antiserum raised against bovine biglycan and sequence of the N-terminal 26 amino acids. Biglycan accounted for approximately 53%, 52% and 38% of PG recovered from zones 1, 2 and 3, respectively. The glycosaminoglycan chains on both decorin and biglycan were identified as dermatan sulphate by their susceptibility to chondroitinase-B. Stains-All staining of SDS gels of Octyl-Sepharose eluates revealed the presence of a third small PG eluting slightly later than biglycan. This PG was purified by a further cycle of chromatography on Octyl-Sepharose and identified as fibromodulin on the basis of its amino acid composition and the N-terminal sequence obtained after digestion with pyroglutamate aminopeptidase. It was obtained in highest amounts from the inner (zone 1) tissue, which also yielded more biglycan and less decorin. Fibromodulin from the meniscus was shown to inhibit the formation of fibrils from a solution of type I collagen, independently of the effects of decorin. These results support the concept that the distributions and characteristics of the small PGs in knee meniscus reflect regional adaptation to functional demands.

Glycosaminoglycans and proteoglycans from different zones of the porcine knee meniscus

Medial and lateral knee menisci were obtained from 20-week-old pigs, dissected into three zones of equal width, and analyzed for collagen and glycosaminoglycan content and for types of glycosaminoglycan and proteoglycan. The thin inner zones contained about 76% collagen and 8% glycosaminoglycan (by dry weight) and the outer zones, 93% collagen and 2% glycosaminoglycan. The most abundant glycosaminoglycan in all zones was chondroitin sulphate, accounting for about 80% of total glycosaminoglycan in the inner zones and 50-56% in the outer zones. Dermatan sulphate was the second most abundant glycosaminoglycan, present relative to chondroitin sulphate in a ratio of about 1:5-6 in the inner zones and 1:1.5 in the outer zones. Hyaluronic acid accounted for 4-5% of total glycosaminoglycan content in the inner zones and 10% in the outer zones. All compositional parameters for the middle zones were between those for the inner and outer zones. There were no statistically significant differences in composition between medial and lateral menisci. Proteoglycans were extracted and separated into two groups (large and small proteoglycans) by gel chromatography and were further characterized by gel electrophoresis. The large proteoglycans stained with use of monoclonal antibodies to chondroitin sulphate and keratan sulphate. Biglycan and decorin, two related dermatan sulphate proteoglycans, were identified in the small proteoglycan pool by their behaviour on gel electrophoresis and by immunostaining with specific antibodies. In the middle and inner zones, biglycan predominated. The observed lower electophoretic mobilities of dermatan sulphate proteoglycans from the inner zone compared with those from the outer zone were explained by the discovery of longer dermatan sulphate chains on the former. Collectively, these results show that the extracellular matrix of knee meniscus varies continuously across its width in a manner consistent with increased compressive loading on the thinner, inside aspect of the structure.

The interactions of 'non-aggregating' proteoglycans

The small proteoglycans decorin, biglycan and fibromodulin were prepared as a mixture from bovine nasal cartilage. The proteoglycans in this mixture were shown to interact with hyaluronate immobilized on Sepharose beads under isotonic conditions. The interaction could be disrupted by increasing the ionic strength of the solvent by enhancing the concentration of NaCl. To further characterize the proteoglycans of this mixture, they were visualized with the glycerol spraying/rotary shadowing technique for electron microscopy. They were shown to have a globular core protein and one or more glycosaminoglycan chains. The molecules, moreover, were organized as multimeric complexes, and their association one with another appeared to be mediated by either core protein or glycosaminoglycan chain interactions. Complexes were shown by rotary shadowing microscopy to associate with hyaluronate in solution. The combined results necessarily as discrete monomers but rather as multimeric complexes. The observations made in this study also suggest that a similar interaction could occur in vivo, where the interaction between small proteoglycans and hyaluronate may have a functional significance in the maintenance of cartilage homeostasis.

Effects of transforming growth factor beta on proteoglycan synthesis by cell and explant cultures derived from the knee joint meniscus

Repair of meniscal tears depends in part upon the ability of the resident fibrochondrocytes to produce new extracellular matrix molecules including proteoglycans. Three culture systems have been used to investigate proteoglycan production by meniscal fibrochondrocytes from the inner, middle and outer zones of medial and lateral menisci of the sheep stifle joint. Cultures of meniscal explants, monolayered cells, and cells encapsulated in alginate beads were labeled with 35SO4H2 for 48 h in the absence and presence of transforming growth factor beta (TGF beta) and the proteoglycans were analysed by Sephacryl S-1000 chromatography. In general, the lateral meniscus produced more proteoglycan than the medial. Explants from the inner and middle zones produced predominantly aggrecan-like proteoglycan, together with a smaller proteoglycan population eluting with an average distribution coefficient of around 0.65. The outer meniscal zones synthesized less proteoglycan overall, the majority of which consisted of the smaller proteoglycans. These characteristic proteoglycan size profiles obtained with explant cultures also were preserved when cells isolated from the respective zones were cultured in alginate beads. Monolayer cell cultures, however, produced almost entirely small proteoglycans, regardless of their zone of origin. Chromatography of chondroitinase AC and ABC digested samples indicated that the small proteoglycan population comprised mostly dermatan sulphate-containing proteoglycans. In all meniscal zones and in all culture systems, TGF beta stimulated proteoglycan production by up to 100% and the proteoglycans were slightly larger. TGF beta also stimulated cell division in fibrochondrocyte monolayer cultures. Long term intermittent stimulation of alginate bead cultures with TGF beta resulted in large increases in proteoglycan synthesis, increased aggregation of large proteoglycan monomers, and an increase in the production of the larger of two small proteoglycans, putatively, biglycan.

Small proteoglycans from different regions of the fibrocartilaginous temporomandibular joint disc

Proteoglycans were isolated from two zones--the periphery and the inner zone--of bovine temporomandibular joint articular discs and separated into two pools by gel-filtration. Proteoglycans in the low molecular mass pool were further resolved by hydrophobic affinity chromatography into two groups identified by cyanogen bromide peptide analysis, amino acid analysis and amino-terminal sequence analysis as PGI (biglycan) and PGII (decorin). These two proteoglycans were isolated in approximately equal proportions from the 'inner' disc tissue but PGII predominated in the 'outer' tissue. Direct chemical analysis showed that the glycosaminoglycan chains on both PGI and PGII were high in iduronate (64-68% of total uronic acid). The dermatan sulfate chains on proteoglycans from the inner disc tissue were longer than those from the outer tissue. Comparison of the galactosamine contents of the intact proteoglycans with electrophoretic mobilities of the isolated dermatan sulfate chains showed that the PGI from the disc carries two dermatan sulfate chains. Inclusion of disc DS-PGI in a solution of soluble type I collagen lengthened the lag-phase, steepened the turbidity-time curve and increased the final opacity attained during fibril formation in vitro. The median fibril diameter and the range of diameters were both higher in the presence of DS-PGI. By contrast, disc DS-PGII reduced the slope of the turbidity-time curve but had little effect on the final turbidity or the fibril diameter.

Proteoglycan heterogeneity in the normal adult ovine intervertebral disc

Proteoglycans (PGs) were isolated from 4 M GuHCl extracts of young adult ovine Intervertebral disc (IVD) tissues using sequential CsCl density gradient centrifugation, and a combination of gel-permeation and hydrophobic chromatography. A total of six PG sub-populations were identified in both the Annulus fibrosus (AF) and Nucleus pulposus (NP), i.e. two high buoyant density aggregatable PGs, two high buoyant density non-aggregatable PGs and two small, low-intermediate buoyant density, non-aggregatable, DS-rich PG species. These latter PGs were identified as biglycan and decorin on the basis of analyses of their core protein native size, and glycosaminoglycan composition. Additional low-intermediate buoyant density PG species were also evident in the non-aggregatable PG pool, particularly in extracts of NP tissues. These PGs did not bind to the octyl affinity matrix under the experimental conditions employed and thus were readily separated from the DS-PGs by hydrophobic chromatography, their constituent glycosaminoglycans (CS and KS) also differed and were of a smaller size to the CS and KS chains isolated from the large high buoyant density PGs, the small PGs which did not bind to octyl-sepharose may therefore represent distinct PG species in their own right. Differences were evident in the absolute size, and in the distribution of individual PG species in the respective IVD tissues but the NP always contained a larger proportion of high buoyant density non-aggregatable PGs of somewhat smaller size than those isolated from the AF. Decorin and biglycan, however, were generally more abundant in AF tissues.

Non-proteoglycan forms of biglycan increase with age in human articular cartilage

Polyclonal anti-peptide antibodies were raised to the C-terminal regions of human biglycan and decorin. These antibodies were used in immunoblotting to study structural variations with age in the proteoglycan core proteins present in extracts of human articular cartilage and intervertebral disc. Three forms of the biglycan core protein were identified. The largest form was detected only after chondroitinase treatment and represents the proteoglycan form of the molecule from which the glycosaminoglycan chains have been removed. However, chondroitinase treatment did not alter the electrophoretic mobility of the two smaller proteins, which appear to represent non-proteoglycan forms of the molecule, resulting either from a failure to substitute the intact proteoglycan core protein with glycosaminoglycan chains during its synthesis or from proteolytic processing of the intact proteoglycan causing removal of the N-terminal region bearing the glycosaminoglycan chains. The non-proteoglycan forms constituted a minor proportion of biglycan in the newborn, but were the major components in the adult. A similar trend was seen in both articular cartilage and intervertebral disc. In comparison, decorin appears to exist predominantly as a proteoglycan at all ages, with two core protein sizes being present after chondroitinase treatment. Non-proteoglycan forms were detected in the adult, but they were always a minor constituent.

Effects of intraarticular hyaluronan on matrix changes induced in the lateral meniscus by total medial meniscectomy and exercise

Total medial meniscectomy was performed in 12 adult merino sheep. Immediately after surgery, 8 animals received high-molecular-weight hyaluronan (HA) (1 mL, 10 mg/mL) and 4 were given sterile saline (1 mL) intraarticularly. Injections were given for 5 more weeks. In week 3 an exercise program, consisting of walking 24 km/wk, was initiated. This program was continued until the animals were killed at week 26 postmeniscectomy. At necropsy the lateral menisci were removed and divided into three concentric zones--inner, middle, and outer. Powdered aliquots of tissues from each zone were analyzed for collagen and hexuronate contents using colormetric methods. The glycosaminoglycans (GAGs)--chondroitin-O-sulfate (C-O-S), chondroitin-4-sulfate (C-4-S), chondroitin-6-sulfate (C-6-S), and dermatan sulfate (DS)--were determined using a high-performance liquid chromatography method. The lateral menisci from the joints of animals injected with HA showed higher hexuronate and GAG levels than those of controls. This increase was mainly due to C-6-S, which had highest levels in the inner and middle meniscal zones. In addition, dermatan sulfate levels increased significantly in the middle and outer zones of the lateral menisci compared with the same zones of the meniscus from the saline-treated group. Collagen and C-O-S levels were not statistically different from those of controls. These data suggest that intraarticular administration of high-molecular-weight HA immediately after open total medial meniscectomy may help preserve the proteoglycans in the lateral meniscus remaining in the joint.